title: [An analysis of palliative surgery for the patients with malignant bowel obstruction].
abstract: OBJECTIVE
  The objective of this study was to clarify the surgical outcome of patients with palliative surgery for malignant bowel obstruction.
  
  
  OBJECTIVE
  This study investigated the clinical features, operative procedures and postoperative course of 35 patients who underwent a palliative surgery for malignant bowel obstruction. And then the patients were divided into two groups; Patients in A group were consisted of 4 patients with hospital death and 7 patients with postoperative complications. Patients in B group were consisted of 24 patients without hospital death or postoperative complications.
  
  
  RESULTS
  Eighteen patients who had been inserted nasogastric tube or ileus tube in the preoperative state could be removed. Thirty-three of 35 patients(94.3%)could become an oral ingestion. Four of 35 patients(11.4%)could not be discharged; 3 patients died of cancer and 1 patient died of acute myocardial infarction. Postoperative complications were seen in 7 patients except 4 patients with hospital death. The median postoperative stay was 18 days(3-58). Twenty six of 35 patients(74.3%) underwent chemotherapy. The median survival time was 137 days(3-1,614). The patients in A group showed a lower level of albumin(p=0.0071)and hemoglobin,(p=0.0006)and poorer performance status(p=0.0178)than the patients in B group. The median hospital stay of the patients in A group and B group were 28 days and 16 days, respectively(p=0.0823). The median survival time of the patients in A group and B group were 42 days and 119 days, respectively(p=0.0035).
  
  
  CONCLUSIONS
  We concluded that the palliative surgery made an oral ingestion possible and improved a quality of life of the patients with malignant bowel obstruction. However, the surgical indication should be carefully decided for the patients with low albumin, hemoglobin and poor performance status.
authors.affiliation: Dept. of Surgery, Teikyo University Chiba Medical Center.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Imai
authors.forename: Hideki
authors.initials: H
authors.lastname: Yasuda
authors.forename: Keiji
authors.initials: K
authors.lastname: Koda
authors.forename: Masato
authors.initials: M
authors.lastname: Suzuki
authors.forename: Masato
authors.initials: M
authors.lastname: Yamazaki
authors.forename: Tohru
authors.initials: T
authors.lastname: Tezuka
authors.forename: Chihiro
authors.initials: C
authors.lastname: Kosugi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirano
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Nakagawa
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Adachi
authors.forename: Risa
authors.initials: R
authors.lastname: Shiragami
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D045823:Ileus / Q000209:etiology / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging; D009369:Neoplasms / Q000150:complications* / Q000473:pathology; D010166:Palliative Care; D011183:Postoperative Complications; D011788:Quality of Life; D012008:Recurrence; D016896:Treatment Outcome